OUR national healthcare system is not something we can talk big about, and the issues women face in the country, especially in rural areas, make for a horrible story. We are all aware of the pregnancy complications that often result in life-threatening situations for women.

A safe pregnancy always leads to a safe delivery and a healthy baby being born. This cycle seems simple, but the reality is contradictory. There are two kinds of pregnancies; normal delivery and caesarean section (CS). The latter involves risk to both the mother and the foetus as it needs special equipment. The CS-related mortality rate is rather high among women in rural Pakistan.

The number of cases affected by CS-related complications is increasing, but the pattern and history have remained the same.

Now let us connect the dots. Most of these cases are mainly from rural areas, where a woman, when admitted for CS procedure, comes face to face with the alarmingly low quality of the healthcare system, and more often than not faces complications. The system is so pathetic that it cannot even take care of the complications, and the patient has to be shifted to the closest city. Not many are able to survive this ordeal and die on the way.

CS rates continue to increase around the world. Recent World Health Organisa-tion (WHO) data suggests that 21 per cent of all childbirths are by CS, and this will increase to 29pc by 2030. These figures are alarming as the procedure carries a risk of infection, haemorrhage and anaesthesia complications for the patient. The CS babies are at a high risk of asthma due to several reasons.

Government hospitals, especially in Sindh, are no longer able to treat patients from the rural areas, and the private hospitals play their game to their hearts’ content. They provide ‘low-cost operations’, which can, and often do, result in death. Nobody is aware of the competence level of the doctors, and knows for sure whether or not there are facilities that are required to perform such procedures. The ability to manage patients in a critical condition is certainly suspect.

The huge number of patients who are brought from rural Sindh to Karachi on life-support is evidence enough that the attending doctors in rural areas are not properly trained, and, as such, are not competent enough to handle complicated cases. The absence of the required facilities makes the situation even trickier.

The government must investigate why so many CS patients end up on ventilators, especially in rural Sindh. We must ensure safety of women by keeping untrained and incompetent health professionals away from carrying out CS and other such procedures.

It is time the provincial government focussed on providing quality health-care to the people in rural areas to ease the burden on the existing health facilities in urban centres, like Karachi.

Arisha Irshad Ali
Karachi

Published in Dawn, April 4th, 2024